WGU D120 OBJECTIVE ASSESSMENT ACTUAL EXAM
STUDY GUIDE COMPLETE QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES
A young woman is complaining of tenderness and burning of her vulva. On exam,
the vulva is edematous and excoriated. The FNP performs a wet mount
preparation of vaginal secretions. It reveals pseudohyphae and spores. What is the
diagnosis for this patient?
vulvovaginal candidiasis;
Pseudohyphae and spores on the wet mount with potassium hydroxide are
diagnostic for candida infection.
A young woman presents with complaints of irritation in the vaginal area. This is
the first time this has occurred. On exam, the cervix is inflamed and friable.
Flagellated protozoa are seen on the wet mount. What is the most likely diagnosis?
trichomoniasis;
Flagellated protozoan confirms the diagnosis of trichomoniasis.
A 21-year-old female patient presents for her first well-woman exam. She has
never been sexually active. Her family history and past medical history are
negative for any gynecologic diseases. Her menses occur every 28 days, lasting 5
,days, with a relatively moderate flow and no significant dysmenorrhea. Her
physical exam should include which tests?
Pap smear;
The recommended age for females to begin screening pap smears is at the age of
21, regardless of sexual activity history. STD screening is not necessary as the
patient is not sexually active. Hemoccult and mammogram are not recommended
for this age group of patient.
A young adult patient presents with a history of vaginal itching and heavy white
discharge. The patient denies a history of sexual activity. On exam, the FNP finds a
red, edematous vulva and white patches on the vaginal walls. The discharge has
no odor. What finding would the FNP suspect in the patient's history?
recent antibiotic use;
Almost half of all vaginal infections are caused by candida. The majority of women
who develop this infection have recently taken antibiotics.
A 46-year-old female patient is being seen in the clinic by the FNP. She was last
seen 2 weeks ago for an upper respiratory tract infection and was treated with
amoxicillin 250mg PO TID x 10days. She completed her medication last week, but
now complains of vaginal itching and thick white discharge. She states that she
has never experienced such intense itching. She is in a mutually monogamous
relationship. Her LMP was 2 weeks ago. Her partner had a vasectomy. Wet mount
shows negative whiff test, rare clue cells, positive lactobacilli, positive hyphae,
positive spores, few WBCs, and no trichomonads. She is leaving tomorrow for a
week long cruise. She is not taking any medications and has no known drug
allergies. The FNP should prescribe which of the following?
,fluconazole 150mg 1 tab PO x1 dose;
Fluconazole is approved for a single-dose oral treatment of uncomplicated
vulvovaginal candidiasis. It is the most convenient treatment for this patient who
will is unlikely to be compliant with vaginal creams given the upcoming travel.
A 25-year-old patient presents with complaints of malodorous vaginal discharge,
which is white and watery. She douches with vinegar and water every 2 weeks.
She uses a diaphragm for contraception and has been sexually active with her
boyfriend for two years, using condoms for STD prevention. Her LMP was 1 week
ago, and there are no noted changes in her normal menstrual pattern. Her wet
mount shows a positive whiff test, clue cells too numerous to count, no
lactobacilli, no hyphae, no spores. What is the diagnosis and treatment for this
patient?
bacterial vaginosis: metronidazole vaginal gel 1 applicator HS x 5 days.;
Metronidazole vaginal gel is the treatment of choice for bacterial vaginosis in the
non-pregnant female. The presence of clue cells, and the associated malodorous
discharge and absence of lactobacilli are markers for the diagnosis of bacterial
vaginosis.
A 41-year-old patient is seen for her 6-week postpartum exam by the FNP. She is
breastfeeding without difficulty and plans to continue for a year. She wants to
begin using contraception and plans no further pregnancies. Which of the
following is not an appropriate choice for this patient?
Combination OC;
, Combination OCs are not recommended for breastfeeding mothers because of the
effect of estrogen on milk supply. Progestin only OCs, IUDs, and Depo-Provera are
acceptable methods of contraception for breastfeeding mothers.
Which two patients should have a Pap smear test performed by the FNP?
Based on USPSTF guidelines, pap smear tests should be performed on female
patients aged 21 and older, regardless of sexual activity.
What finding is considered a normal surface characteristic of the cervix?
Small, yellow, raised round area on the cervix.
Red patches with occasional white spots.
Friable, bleeding tissue at the opening of the cervical os.
Irregular granular surface with red patches.
Small, yellow, raised round area on the cervix.;
A nabothian cyst is a small, white or yellow, raised round area on the cervix and is
considered to be a normal variant.
The FNP is reviewing the lab results of a 28-year-old patient recently seen for a
pap smear. Classification is high-grade squamous intraepithelial lesion,
endocervical cells seen, and adequate smear. The FNP phones the patient and
tells her which of the following?
STUDY GUIDE COMPLETE QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES
A young woman is complaining of tenderness and burning of her vulva. On exam,
the vulva is edematous and excoriated. The FNP performs a wet mount
preparation of vaginal secretions. It reveals pseudohyphae and spores. What is the
diagnosis for this patient?
vulvovaginal candidiasis;
Pseudohyphae and spores on the wet mount with potassium hydroxide are
diagnostic for candida infection.
A young woman presents with complaints of irritation in the vaginal area. This is
the first time this has occurred. On exam, the cervix is inflamed and friable.
Flagellated protozoa are seen on the wet mount. What is the most likely diagnosis?
trichomoniasis;
Flagellated protozoan confirms the diagnosis of trichomoniasis.
A 21-year-old female patient presents for her first well-woman exam. She has
never been sexually active. Her family history and past medical history are
negative for any gynecologic diseases. Her menses occur every 28 days, lasting 5
,days, with a relatively moderate flow and no significant dysmenorrhea. Her
physical exam should include which tests?
Pap smear;
The recommended age for females to begin screening pap smears is at the age of
21, regardless of sexual activity history. STD screening is not necessary as the
patient is not sexually active. Hemoccult and mammogram are not recommended
for this age group of patient.
A young adult patient presents with a history of vaginal itching and heavy white
discharge. The patient denies a history of sexual activity. On exam, the FNP finds a
red, edematous vulva and white patches on the vaginal walls. The discharge has
no odor. What finding would the FNP suspect in the patient's history?
recent antibiotic use;
Almost half of all vaginal infections are caused by candida. The majority of women
who develop this infection have recently taken antibiotics.
A 46-year-old female patient is being seen in the clinic by the FNP. She was last
seen 2 weeks ago for an upper respiratory tract infection and was treated with
amoxicillin 250mg PO TID x 10days. She completed her medication last week, but
now complains of vaginal itching and thick white discharge. She states that she
has never experienced such intense itching. She is in a mutually monogamous
relationship. Her LMP was 2 weeks ago. Her partner had a vasectomy. Wet mount
shows negative whiff test, rare clue cells, positive lactobacilli, positive hyphae,
positive spores, few WBCs, and no trichomonads. She is leaving tomorrow for a
week long cruise. She is not taking any medications and has no known drug
allergies. The FNP should prescribe which of the following?
,fluconazole 150mg 1 tab PO x1 dose;
Fluconazole is approved for a single-dose oral treatment of uncomplicated
vulvovaginal candidiasis. It is the most convenient treatment for this patient who
will is unlikely to be compliant with vaginal creams given the upcoming travel.
A 25-year-old patient presents with complaints of malodorous vaginal discharge,
which is white and watery. She douches with vinegar and water every 2 weeks.
She uses a diaphragm for contraception and has been sexually active with her
boyfriend for two years, using condoms for STD prevention. Her LMP was 1 week
ago, and there are no noted changes in her normal menstrual pattern. Her wet
mount shows a positive whiff test, clue cells too numerous to count, no
lactobacilli, no hyphae, no spores. What is the diagnosis and treatment for this
patient?
bacterial vaginosis: metronidazole vaginal gel 1 applicator HS x 5 days.;
Metronidazole vaginal gel is the treatment of choice for bacterial vaginosis in the
non-pregnant female. The presence of clue cells, and the associated malodorous
discharge and absence of lactobacilli are markers for the diagnosis of bacterial
vaginosis.
A 41-year-old patient is seen for her 6-week postpartum exam by the FNP. She is
breastfeeding without difficulty and plans to continue for a year. She wants to
begin using contraception and plans no further pregnancies. Which of the
following is not an appropriate choice for this patient?
Combination OC;
, Combination OCs are not recommended for breastfeeding mothers because of the
effect of estrogen on milk supply. Progestin only OCs, IUDs, and Depo-Provera are
acceptable methods of contraception for breastfeeding mothers.
Which two patients should have a Pap smear test performed by the FNP?
Based on USPSTF guidelines, pap smear tests should be performed on female
patients aged 21 and older, regardless of sexual activity.
What finding is considered a normal surface characteristic of the cervix?
Small, yellow, raised round area on the cervix.
Red patches with occasional white spots.
Friable, bleeding tissue at the opening of the cervical os.
Irregular granular surface with red patches.
Small, yellow, raised round area on the cervix.;
A nabothian cyst is a small, white or yellow, raised round area on the cervix and is
considered to be a normal variant.
The FNP is reviewing the lab results of a 28-year-old patient recently seen for a
pap smear. Classification is high-grade squamous intraepithelial lesion,
endocervical cells seen, and adequate smear. The FNP phones the patient and
tells her which of the following?
